Form 990-ez, Part I, Line 16
“Expenses advertising & promotional mat 1,555 travel 13 meetings expenses 729 total 2,297”
Rock River Free Medical Clinic Inc
990EZ • Fiscal year 2018 • EIN 47-0898219
Siviq Scores
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Balance Sheet
Assets
Flat$139,280
Flat from 2018
Net Assets
Flat$128,436
Flat from 2018
Liabilities
Flat$10,844
Flat from 2018
Revenue And Expenses
Revenue
Flat$121,292
Flat from 2018
Expenses
Flat$89,243
Flat from 2018
Net Income
Flat$32,049
Flat from 2018
Historical Trend
Jump To
Filing Snapshot
- Filing Period
- Jan 1, 2018 to Dec 31, 2018
- Signed
- Jan 6, 2019
- Return Version
- 2018v3.1
- Gross Receipts
- $121,292
Mission and Program Overview
Mission
Primary care medical clinic which provides physician services and medication acquisition assistance at no cost for low income, uninsured residents of jefferson county wi.
Primary care medical clinic which provides physician services and medication acquisition assistance at no or low cost for low income and uninsured residents of jefferson county wi.
Program Services
| Description | Grants | Expenses |
|---|---|---|
| PRIMARY CARE MEDICAL CLINIC WHICH PROVIDES PHYSICIAN SERVICES AND MEDICATION ACQUISITION ASSISTANCE AT NO OR LOW COST FOR LOW INCOME AND UNINSURED RESIDENTS OF JEFFERSON COUNTY WI. IN 2018, WE SERVED IN EXCESS OF 790 PATIENTS WITH OVER 2000 PATIENT VISITS. | - | $40,507 |
| PRIMARY CARE MEDICAL CLINIC WHICH PROVIDES PHYSICIAN SERVICES AND MEDICATION ACQUISITION ASSISTANCE AT NO OR LOW COST FOR LOW INCOME AND UNINSURED RESIDENTS OF JEFFERSON COUNTY WI. | - | - |
Compensation and Service Providers
Employees
| Name | Title | Full / Part Time | Base | Other | Total |
|---|---|---|---|---|---|
| KRISTIN WALLACE | Executive Di | PT | $30,501 | - | $30,501 |
| DR DAVID RUTLEDGE | Medical Dire | - | $0 | - | - |
| LAURIE SCHIMEK | Chairperson | - | $0 | - | - |
| CHRISTOPHER ROGERS | Vice-Chairpe | - | $0 | - | - |
| KATRINA WALDRON | Secretary | - | $0 | - | - |
| LUKE WALSH | Treasurer | - | $0 | - | - |
| DEB KIND-HALL | Board Member | - | $0 | - | - |
| DIANE LUNDE | Board Member | - | $0 | - | - |
| KIM PROPP | Board Member | - | $0 | - | - |
| PAUL JOHNSON | Board Member | - | $0 | - | - |
Filing and Contact Details
Filer
- Filer Name
- Rock River Free Medical Clinic Inc
- EIN
- 47-0898219
- Phone
- 9206747442
- Address
- 1541 ANNEX ROAD, JEFFERSON, WI 53549
Signing Officer
- Name
- Kristin Wallace
- Title
- Executive Director
- Phone
- 9206747442
- Signed
- 2019-01-06
- Discuss with paid preparer
- Yes
Preparer
- Firm
- Luke W Walsh CPA LLC
- Address
- 524 WHITEWATER AVENUE, FORT ATKINSON, WI 53538-2352
- Preparer
- Luke W Walsh CPA
- Phone
- 9205637573
Supplemental Narrative
Additional Explanations
Form 990-ez, Part II, Line 26
“Accounts payable and accrued expenses 874 844 deferred revenue 10,000 10,000”
Form 990-ez, Part III
“Primary care medical clinic which provides physician services and medication acquisition assistance at no or low cost for low income and uninsured residents of jefferson county wi.”
Form 990-ez, Part III, Line 28
“Primary care medical clinic which provides physician services and medication acquisition assistance at no or low cost for low income and uninsured residents of jefferson county wi. In 2018, we served in excess of 790 patients with over 2000 patient visits.”
Form 990-ez, Part III, Line 31
“Primary care medical clinic which provides physician services and medication acquisition assistance at no or low cost for low income and uninsured residents of jefferson county wi.”
Raw XML Appendix196 raw XML fields
This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.
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| IRS990EZ/OrganizationHadUBIInd | 0 | false |
| IRS990EZ/OtherExpensesTotalAmt | 0 | 2297 |
| IRS990EZ/PartVIHghstPdCntrctProfSrvcTxt | 0 | NONE |
| IRS990EZ/PartVIOfCompOfHghstPdEmplTxt | 0 | NONE |
| IRS990EZ/PoliticalCampaignActyInd | 0 | false |
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| IRS990EZ/TransactionWithControlEntInd | 0 | false |
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| IRS990ScheduleA/InvestmentIncomeAndUBTIGrp/TotalAmt | 0 | 490 |
| IRS990ScheduleA/InvestmentIncomeCYPct | 0 | 0.00000 |
| IRS990ScheduleA/InvestmentIncomePYPct | 0 | 0.00000 |
| IRS990ScheduleA/PubliclySupportedOrg509a2Ind | 0 | X |
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| IRS990ScheduleA/PublicSupportTotal509Amt | 0 | 525017 |
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| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 0 | EXPENSES ADVERTISING & PROMOTIONAL MAT 1,555 TRAVEL 13 MEETINGS EXPENSES 729 TOTAL 2,297 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 1 | ACCOUNTS PAYABLE AND ACCRUED EXPENSES 874 844 DEFERRED REVENUE 10,000 10,000 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 2 | PRIMARY CARE MEDICAL CLINIC WHICH PROVIDES PHYSICIAN SERVICES AND MEDICATION ACQUISITION ASSISTANCE AT NO OR LOW COST FOR LOW INCOME AND UNINSURED RESIDENTS OF JEFFERSON COUNTY WI. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 3 | PRIMARY CARE MEDICAL CLINIC WHICH PROVIDES PHYSICIAN SERVICES AND MEDICATION ACQUISITION ASSISTANCE AT NO OR LOW COST FOR LOW INCOME AND UNINSURED RESIDENTS OF JEFFERSON COUNTY WI. IN 2018, WE SERVED IN EXCESS OF 790 PATIENTS WITH OVER 2000 PATIENT VISITS. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 4 | PRIMARY CARE MEDICAL CLINIC WHICH PROVIDES PHYSICIAN SERVICES AND MEDICATION ACQUISITION ASSISTANCE AT NO OR LOW COST FOR LOW INCOME AND UNINSURED RESIDENTS OF JEFFERSON COUNTY WI. |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | FORM 990-EZ, PART I, LINE 16 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | FORM 990-EZ, PART II, LINE 26 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 2 | FORM 990-EZ, PART III |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 3 | FORM 990-EZ, PART III, LINE 28 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 4 | FORM 990-EZ, PART III, LINE 31 |
| ReturnHeader/BuildTS | 0 | 2019-02-21 02:37:17Z |
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| ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt | 0 | 66.188.124.94 |
| ReturnHeader/FilingSecurityInformation/IPDt | 0 | 2019-01-09 |
| ReturnHeader/FilingSecurityInformation/IPTimezoneCd | 0 | CS |
| ReturnHeader/FilingSecurityInformation/IPTm | 0 | 14:32:05 |
| ReturnHeader/PreparerFirmGrp/PreparerFirmEIN | 0 | 300608892 |
| ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt | 0 | LUKE W WALSH CPA LLC |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt | 0 | 524 WHITEWATER AVENUE |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm | 0 | FORT ATKINSON |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd | 0 | WI |
| ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd | 0 | 535382352 |
| ReturnHeader/PreparerPersonGrp/PhoneNum | 0 | 9205637573 |
| ReturnHeader/PreparerPersonGrp/PreparationDt | 0 | 2019-01-09 |
| ReturnHeader/PreparerPersonGrp/PreparerPersonNm | 0 | LUKE W WALSH CPA |
| ReturnHeader/ReturnTs | 0 | 2019-01-09T14:32:05-06:00 |
| ReturnHeader/ReturnTypeCd | 0 | 990EZ |
| ReturnHeader/TaxPeriodBeginDt | 0 | 2018-01-01 |
| ReturnHeader/TaxPeriodEndDt | 0 | 2018-12-31 |
| ReturnHeader/TaxYr | 0 | 2018 |
Document Assets
No mirrored PDF or thumbnail assets are attached yet.
Filings
Displayed year
2018 • Form 990EZDetailed filing. Detailed filing data is available for this year.
- Assets
- $139,280
- Liabilities
- $10,844
- Net assets
- $128,436
- Revenue
- $121,292
- Expenses
- $89,243
- Net income
- $32,049